How much rates vary
Facilitymedian $1,585 · 10th to 90th $468 to $3,162Professionalmedian $1,380 · 10th to 90th $363 to $4,677
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $316.23 Median $1,047.13 Typical High $14,454.40 | Facility | None | $316.23 | $1,047.13 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,047.13 Typical High $3,388.44 | Professional | None | $316.23 | $1,047.13 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,584.89 | Facility | None | $1,174.90 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $1,621.81 Typical High $5,495.41 | Professional | None | $457.09 | $1,621.81 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $676.08 Median $2,454.71 Typical High $8,317.64 | Professional | 50 · Both sides | $676.08 | $2,454.71 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,630.78 | Facility | None | $2,137.96 | $2,398.83 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $912.01 Typical High $2,951.21 | Professional | None | $407.38 | $912.01 | $2,951.21 |
DeanCare Setting Facility Modifier None Typical Low $371.54 Median $2,754.23 Typical High $5,128.61 | Facility | None | $371.54 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $426.58 Median $891.25 Typical High $2,187.76 | Professional | None | $426.58 | $891.25 | $2,187.76 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $1,348.96 Typical High $3,235.94 | Professional | 50 · Both sides | $645.65 | $1,348.96 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,445.44 Typical High $1,778.28 | Facility | None | $467.74 | $1,445.44 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $3,162.28 Typical High $7,244.36 | Professional | None | $1,148.15 | $3,162.28 | $7,244.36 |
Network Health Setting Facility Modifier None Typical Low $831.76 Median $1,819.70 Typical High $2,344.23 | Facility | None | $831.76 | $1,819.70 | $2,344.23 |
Network Health Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $2,691.53 | Professional | None | $616.60 | $1,230.27 | $2,691.53 |
Prevea360 Setting Facility Modifier None Typical Low $257.04 Median $524.81 Typical High $1,584.89 | Facility | None | $257.04 | $524.81 | $1,584.89 |
Quartz Setting Professional Modifier None Typical Low $380.19 Median $1,000.00 Typical High $3,548.13 | Professional | None | $380.19 | $1,000.00 | $3,548.13 |
Quartz Setting Professional Modifier None Typical Low $407.38 Median $831.76 Typical High $1,659.59 | Professional | None | $407.38 | $831.76 | $1,659.59 |
Security Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $4,466.84 | Professional | None | $1,230.27 | $1,230.27 | $4,466.84 |
Security Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $6,165.95 | Professional | None | $1,258.93 | $1,905.46 | $6,165.95 |
The Alliance Setting Professional Modifier None Typical Low $363.08 Median $1,047.13 Typical High $1,548.82 | Professional | None | $363.08 | $1,047.13 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,023.29 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,122.02 Typical High $3,715.35 | Professional | None | $371.54 | $1,122.02 | $3,715.35 |
11 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $158.49 Median $158.49 Typical High $524.81 | Facility | 52 · Reduced service | $158.49 | $158.49 | $524.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $208.93 | Facility | 53 · Discontinued | $63.10 | $63.10 | $208.93 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $794.33 | Facility | 54 · Surgery only | $234.42 | $234.42 | $794.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $158.49 | Facility | 55 · Aftercare only | $46.77 | $46.77 | $158.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $104.71 | Facility | 56 · Pre-op care only | $31.62 | $31.62 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $524.81 Typical High $1,995.26 | Professional | 52 · Reduced service | $158.49 | $524.81 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $208.93 Typical High $794.33 | Professional | 53 · Discontinued | $63.10 | $208.93 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $794.33 Typical High $3,019.95 | Professional | 54 · Surgery only | $234.42 | $794.33 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $158.49 Typical High $602.56 | Professional | 55 · Aftercare only | $46.77 | $158.49 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $104.71 Typical High $398.11 | Professional | 56 · Pre-op care only | $31.62 | $104.71 | $398.11 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $213.80 Median $446.68 Typical High $1,096.48 | Professional | 51 · Multiple procedures | $213.80 | $446.68 | $1,096.48 |
Where Wisconsin sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 1st of 51
$1,380
WI $1,380HI $324
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.